Managing Worker Dosimetry
with Decreasing Resources
in Very Large Mass Casualty Radiation Incident

Increasing Severity of the Incident

Resource Availability		Sufficient	Incomplete	Insufficient
Operating Conditions		Equipment and personnel are adequate for response. Routine timelines for deploying, reviewing and recording dosimetry readings are in place.	Operations equivalent to normal but with constrained resources. Routine dosimetry operations may start to be modified due to incident.	Insufficient resources to meet most dosimetry needs. High-radiation levels increase risk to responders. Alternate uses of dosimetry equipment and dose tracking routines must be implemented.
Response Resource Adequacy	Equipment	Appropriate alarming dosimeters for each worker category. Dose management takes place as identified under existing plans. Normal archiving of dose data into existing logs or registry.	Dosimeters for each worker category, but alarming dosimeter resources may be strained. Strategic plan to manage dose for all responders is implemented. Exposure data are recorded, but archiving of data into databases may be delayed as real-time monitoring of dose(s) takes precedence.	Prioritization of equipment for high-risk responders. Equipment substitution and adaptation necessary. Exposure data are recorded, but archiving of dose data is delayed as real-time monitoring of doses for those at highest risk takes precedence.
	Staff	Adequate numbers of trained staff available to disseminate dosimetry equipment, respond to the incident, track/record doses, and manage responder safety.	Staff available to perform critical response tasks with potential dose-driven time constraints. Few if any responders approach “crisis dose levels” [e.g., >5 rem (50 mSv)]; any who do approach dose limits require prior consent. Limited surge workers may be needed; may require just-in-time training before disseminating dosimetry equipment, responding to the incident, or tracking/recording doses. Some workers may need to be excluded from response (e.g., pregnant, immunosuppressed).	Insufficient staffing for some tasks prior to arrival of surge work force. Prioritization of response activities. Many responders may exceed the regulatory dose limits [e.g., >5 rem (50 mSv)]; responders may exceed regulatory limits. Additional dose controls are needed to ensure responder safety. Some workers may need to be excluded from response (e.g., pregnant, immunosuppressed). Permanent archiving of data may be delayed while operations in crisis mode. Large number of surge workers needed; will require just-in-time training before disseminating dosimetry equipment, responding to the incident, or tracking/recording doses.

Trigger:

• Uncontrolled release of a large quantity of radioactive material
• Large hot zone areas >10 mR h^–1 (~0.1 mSv h^–1)
• Surge of external resources necessary for adequate response

Source:
Adapted from Guidance for Emergency Response Dosimetry (NCRP Report No. 179, Oct 2017, page 70), Bethesda, MD, 2017.